The Complete Guide to Fatigue Management
Are you feeling exhausted and tired? Most of the time, this is just a signal from your body that it needs a break. You should only take a closer look if fatigue is permanently affecting your performance. The main causes of persistent fatigue are lack of sleep, physical and mental exertion, and overwork. But diseases and medication can also make you chronically tired. Read more about the causes of fatigue and what you can do about it.
- What is fatigue? Basically, normal body condition that signals the need for rest. Persistent tiredness can also be a sign of a health disorder or illness. Often accompanied by lack of drive, listlessness and decreasing physical / mental performance.
- Causes: e.g., chronic lack of sleep, lack of exercise, fatty, high-calorie food, overweight, malnutrition, lack of fluids, stress / burnout, boredom, poorly ventilated rooms, toxins and pollutants in the environment, various diseases (such as infections, sleep apnoea, hypothyroidism, diabetes mellitus, cancer, depression, cardiac arrhythmia, migraine), medication, alcohol.
- When to the doctor? For unexplained or prolonged tiredness. For fatigue-related impairment of physical / mental performance. With additional symptoms such as night sweats, dry mucous membranes, blood in the stool, swollen lymph nodes, severe thirst. When tiredness cannot be alleviated with sleep, rest, and exercise in the fresh air.
- Examinations: physical examination, blood tests, possibly examination in the sleep laboratory with electroencephalography (EEG), electrocardiography (ECG), gastroenterological examinations, etc.
- Treatment: depending on the cause, e.g., B. Dietary changes, treatment of underlying medical conditions (such as medication for iron deficiency or hypothyroidism, breathing mask, bite splint or surgical correction for sleep apnoea), behavioural therapy and regular exercise for mental illnesses.
- What you can do yourself: live according to your inner clock, if possible, short naps during the day (power napping), balanced, vitamin-rich, low-fat diet, drink enough (water, tea, etc.), if possible, no alcohol or nicotine, regular exercise and sport, cold Showers / contrast showers, stress reduction, relaxation exercises.
Fatigue in itself is not a disease. Rather, it is a natural signal from the body that it needs rest and breaks (e.g., due to an acute lack of sleep) or that it is lacking in certain nutrients.
It is different if someone is constantly tired and exhausted and maybe even tends to nod off during the day. Then there is often listlessness, listlessness and reduced physical and/or mental performance. All of these are signs that something is wrong.
Fatigue & sleep
Lack of sleep is very often the reason for fatigue. But how much sleep does a person need? This varies greatly from person to person – some people are born sleepers a lot, others generally get by with less sleep.
Age also plays a role: Babies sleep an average of 17 hours out of 24 in the first three months of life. This average sleep time drops to around 14 hours by the end of the first year of life. On average, two-year-olds need around 13 hours of sleep, and four-year-olds around 12 hours. By the age of six, children can usually get by with 11 hours of sleep.
Adults don’t have to sleep as long to be fit the next day: 40-year-olds usually sleep about seven hours at night. The need for sleep generally decreases with age. For a healthy 80-year-old, about six hours of sleep at night are usually enough. But as mentioned – these are all just guidelines. Everyone has their own personal need for sleep.
Tiredness can have various causes and does not necessarily have to be a sign of illness. An unhealthy lifestyle often causes fatigue. Below is a list of the main causes of fatigue.
- Chronic lack of sleep: going to bed too late, getting up early, living against the natural sleep-wake cycle
- Lack of exercise: If you don’t move enough over a long period of time, you will get tired more quickly
- Fatty, high-calorie food: After an opulent meal, more blood flows into the digestive organs. Other regions such as the brain are then less supplied with blood and thus less oxygen – you get tired
- Diets or underweight: If the body is not supplied with enough nutrients, minerals and vitamins, symptoms of deficiency can occur, which in turn can trigger fatigue
- Dehydration: If you drink too little, the blood becomes viscous and can only circulate slowly. In this way, the brain is also supplied with oxygen in a delayed manner so it’s important to drink enough. For adults, two litres of liquid per day (at moderate temperatures) are recommended
- Stress at work or in everyday life, burnout, and persistent under-challenge (boredom, bore out) make you tired
- Poorly ventilated rooms and dry air
- Toxic and pollutants in the air (work, living spaces)
Diseases as a cause of fatigue
In addition, various diseases can be accompanied by fatigue. The most important examples are:
- Infections: The immune system runs at full speed to fight off the pathogens (e.g., viruses). Persistent fatigue is often the result. This happens, for example, with influenza, colds, pneumonia, and mononucleosis. Under certain circumstances, tiredness can persist for a long time after the infection has subsided (e.g., after the flu)
- Sleep apnoea: The nocturnal apnoea interrupts sleep repeatedly and thus prevents a restful night’s sleep. As a result, those affected are often extremely tired during the day
- Anaemia: Tiredness, reduced performance, dizziness and headaches are common symptoms of anaemia and the associated lack of oxygen supply to the body. Possible causes of anaemia are, for example, a lack of iron, vitamin B12 or folic acid, bleeding, infections, autoimmune or genetic diseases
- Cardiac arrhythmias
- Metabolic diseases such as hypothyroidism (hypothyroidism) or diabetes (diabetes mellitus)
- Cancer: For example, fatigue is an early symptom of blood cancer (leukaemia) and lymph gland cancer (lymphoma). Cancer therapies (e.g., chemotherapy, radiation) also cause fatigue as a side effect. This is generally referred to as tumour-related fatigue, which almost all cancer patients suffer from at least temporarily
- Other chronic physical diseases such as heart failure (heart failure), multiple sclerosis rheumatoid arthritis, sarcoidosis, or chronic kidney failure (chronic renal failure)
- Mental illnesses such as depression and anxiety disorders can also be associated with fatigue. If symptoms such as tiredness and depression always occur in the winter months, you may have winter depression (seasonal affective disorder, SAD)
- Low blood pressure (hypotension)
Tiredness from medication or addictive substances
Certain medications can make you tired. These include antidepressants, neuroleptics (medicines for psychotic symptoms such as hallucinations), antihypertensives and medicines for allergies (antihistamines).
All addictive substances can also lead to fatigue. This applies to alcohol, but also to other addictive substances such as tobacco or illegal drugs.
Chronic Fatigue Syndrome
Chronic fatigue syndrome (CFS) should be distinguished from tiredness caused by lack of sleep, stress, anaemia, cancer, and the like. It is also called chronic fatigue syndrome. It is a complex and elusive condition associated with prolonged fatigue for no apparent reason. Other symptoms such as insomnia, sore throat and muscle pain also occur at the same time. The exact cause of CFS is unknown.
The clinical picture is often abbreviated to ME/CFS. ME stands for Myalgic Encephalomyelitis – i.e., an inflammation of the central nervous system involving muscles, which is considered to be the cause of chronic fatigue syndrome.
Fatigue: when do you need to see a doctor?
Everyone knows that fatigue is a natural sign that the body needs a break. However, if you are tired frequently and for a long period of time, you should consult a doctor to rule out any medical conditions as the cause.
Frequent fatigue can indicate a serious illness. This is especially true if there are additional symptoms such as night sweats, dry mucous membranes, blood in the stool, swollen lymph nodes or unusually strong thirst. Then you should definitely see a doctor.
Other reasons to see a doctor include:
- Tiredness cannot be combated with sleep, rest and exercise in the fresh air
- The fatigue lasts longer than you are used to
- Fatigue attacks severely impair your physical and mental performance at work and/or in everyday life
- You get tired without making an exceptional effort
- Tiredness remains without being replaced by lively, awake phases
Fatigue: what does the doctor do?
At the beginning, the doctor will take your medical history (anamnesis) in an initial consultation in order to find clues to the cause of the tiredness. You should talk openly and honestly about your life situation and possible problems, otherwise the doctor may not be able to help you. Possible questions in the anamnesis interview are, for example:
- How bad is the tiredness? How long does it last? What is the course of tiredness during the day?
- Are there any other complaints associated with this?
- Is the tiredness new and unfamiliar to you?
- Do you fall asleep at the wheel?
- Does fatigue affect you in everyday life?
- Do you suffer from symptoms of depression or anxiety?
- How well and how long do you sleep at night?
- Do you snore?
- What is your social, professional, and family situation (worries, stress, too much / too little, etc.)?
- Have you gained or lost a lot of weight lately?
- Have you had an infection lately?
- Do you suffer from a chronic illness?
- Do you regularly take medication?
- Do you use drugs?
- Are you regularly exposed to harmful environmental influences (e.g., working with toxins and pollutants, noise pollution)?
The medical history is followed by a physical examination. The focus is on the lymphatic regions, the heart, the respiratory tract, the gastrointestinal and urogenital tract as well as the function of the nervous system and muscles. For this purpose, the doctor can carry out blood tests, a blood sugar measurement, an examination in a sleep laboratory with recording of the brain waves (EEG) and/or an electrocardiography (ECG).
If the doctor has identified an underlying disease as the cause of your tiredness, he will recommend the appropriate therapy. Some examples:
Infections such as influenza or colds – and with them tiredness – usually disappear on their own after a few days when the body has fought the pathogens. It may be possible, for example, to relieve the symptoms and support the healing process with antipyretics, expectorants, inhalations, etc.
Iron-rich foods usually help with anaemia due to iron deficiency. The trace element is found in plant foods such as whole grains, green leafy vegetables (broccoli, spinach), beetroot and nuts. However, the body can better utilize iron from animal products (e.g., meat). If you have a severe iron deficiency, your doctor will also prescribe an iron supplement.
If the anaemia is triggered by a lack of folic acid or vitamin B12, appropriate dietary supplements can also help.
An underactive thyroid can be treated well with medication. Those affected usually must take artificial thyroid hormones for life.
Cognitive behavioural therapy combined with regular exercise can help with mental illness. If necessary, medication will also be prescribed.
Sleep apnoea is usually caused by being overweight. Those affected should therefore lose weight as much as possible. A few kilos less are usually enough to breathe more regularly at night and sleep better. If you also avoid alcohol and sleep on your side, you can get even better control of the nocturnal breathing pauses. If all of this is not enough, breathing masks, bite splints or surgical corrections can be considered.
Fatigue: what you can do yourself
You can do a lot yourself to keep yourself fit and efficient and to prevent attacks of fatigue. But first make sure that the tiredness is not due to a serious illness.
- If possible, live according to your internal clock: Some people are fitter and more efficient in the morning hours, while others only reach their maximum level of performance in the evening. Try to align your everyday activities and your night’s sleep with your internal clock as much as possible
- A short sleep in between (power napping) helps to recharge the batteries and protects against fatigue attacks
- Eat a balanced, vitamin-rich and low-fat diet and avoid being overweight
- Drink enough, around two litres a day. We recommend water, unsweetened tea and fruit juice spritzer
- Consume alcohol in moderation and do not smoke
- Exercise regularly to stimulate circulation. But don’t overdo it, because too much exercise can also be exhausting
- With a cold shower or alternating showers, you get your circulation going in the morning and banish tiredness
- Try to reduce stress (work, family) and ideally learn a relaxation technique such as yoga, autogenic training, or progressive muscle relaxation
- Some medications make you tired. Ask your treating doctor whether it would be possible to switch to an alternative preparation that causes less fatigue
Overall, fatigue can be treated – but usually only through changes in lifestyle and daily routine. In addition, the successes do not appear overnight, but step by step. Give yourself the time you need.